Tears stream down Fatmata’s face as she shuffles into the police station courtyard, alone and doubled over in pain after being held down and beaten with a stick.

She is 26 and says it is not her first battering. This time, though, she is pressing criminal charges against her husband and his girlfriend.

Sitting on a bench and waiting for an officer to take her statement, she wipes her nose and clutches her side. “I am in terrible pain,” she says.

Domestic violence is a problem all over West Africa, not least in Sierra Leone, a nation of 6 million that became synonymous with “blood diamonds,” sexual violence and hacked-off limbs in the civil war that ended in 2002.

Today Sierra Leone can take pride in having an elected government and a five-year-old law criminalizing domestic violence. It has more than 40 police units dedicated to resolving family cases including domestic violence.

“If you won’t help her, who will?” says a billboard that shows a man about to club a terrified woman while another man tries to restrain him.

But what the country lacks, despite its wealth in diamonds, gold, titanium and bauxite, is the money to enforce the law. Nearly two thirds of its people live on less than $1.25 a day, and fewer than a quarter of Sierra Leone women can read and write.

Leaving a violent relationship can be difficult for women in any country, but in Sierra Leone it is almost impossible.

A woman who refuses to have sex with her husband can be summoned to appear before traditional leaders for a reprimand. Even in death, a husband still has control. His widow can be forced to marry his brother or lose her home, land and children.

A man can take up with another woman and the mother of his children will be left with no legal recourse.

Violence toward women was rampant in the lawless 1990s. “Even before the war things were difficult, but the war made things worse,” says Juliana Konteh, the evangelist missionary who founded the Women in Crisis Movement to care for those raped and displaced in the civil war.

Konteh’s is one of the few organizations that operate safe houses for battered women in Sierra Leone.

In 2012 police investigated more than 4,000 cases of suspected domestic violence, and close to 800 people were charged.

But the figures do not tell the whole story. Authorities acknowledge that convictions are rare. The International Rescue Committee, a U.S.-based nonprofit that works to prevent violence against women, says in a report: “A shortage of personnel at all levels leads to delays and case withdrawals, in part from the strong family pressure to settle out of court.”

The 2007 law sets a maximum penalty of two years in prison and a fine of 5 million leone (about $1,200). But neither helps the victim much if it puts a family breadwinner in prison while the fine drains away housekeeping money.

And the police also lack basics. One officer interviewing a victim had to stop and go out to buy a pen.

There is another problem: attitudes toward physical abuse do not change in a hurry.

According to data collected by the government, 63 percent of women questioned in 2008 said it was “acceptable for a husband to beat his wife under certain circumstances,” said Deanne Evans of the International Rescue Committee, which sponsored the billboards.

Fatmata, whose last name was withheld by The Associated Press for her safety, says she has been with her common-law husband since she was 14. Together they’ve now had four children, one of whom died.

To have her injuries assessed, Fatmata must go to Connaught Hospital, which has the only doctor in the country who is authorized to testify about such cases in court. She has brought her baby, Mohamed, 8 months old.

It will cost 25,000 leone ($6) for the medical report required to bring charges. It is no small sum for Fatmata, who sells slippers and cosmetics to augment her partner’s salary as a motorcycle taxi driver.

She finally enters the doctor’s office and sits on a black chair with burst upholstery. It is 4:30 p.m. and she is the 40th case of the day.

Dr. Rashida Kamara feels the top of Fatmata’s head for swelling, and she winces when her side is touched. The doctor writes a prescription for painkillers and an order for an X-ray of her ribs. She stamps a form that Fatmata must now bring back to the police station.

The X-ray technician tells her the price: 160,000 leone ($37). “No money, no X-ray,” he says.

Fatmata leaves, saying she will not be coming back.

The only place to go is home. Getting a protective court order could take at least a day and possibly additional fees. She cannot even afford to fill the prescription for pain medication.

Ibrahim, her husband, is waiting for her.

The two say nothing to each other as she enters the room and sits on a bed in the corner with her baby now fast asleep from the car ride home.

“She’s been doing business upcountry without my knowledge and has another husband there. She should bring all the children for blood tests,” Ibrahim says angrily.

He acknowledges he has another girlfriend, and says she was the one who hit Fatmata but only after Fatmata began chasing her.

As people start to trickle into the room to watch the family drama unfold, Ibrahim says he does not know why Fatmata has come back to the house at all, much less with a baby he now says is not even his.

“She’s not going to sleep here,” he says. “This woman is not allowed here.”

At one point, Fatmata had vowed to pursue a prosecution. At another, she said she saw no alternative but to stay with Ibrahim, because “There is no one to take care of the children except for me.”

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